Robert Picardo yet again delivers a great performance in this episode. Kate Mulgrew is also on point, although I am very disappointed with Janeway's behavior. She still treats the doctor like a lifeless thing and a computer program that can be changed and reset whenever something seems broken. That doesn't fit to the white knight attitude of Janeway in other episodes and her protectiveness towards the crew.
The doctor is sentient. He isn't a corporeal being but from his thoughts and his actions, I don't see any difference to Data. In fact, the doctor is even able to feel as he has proven in several episodes which Data tried to achieve for a long time without any success.
Janeway's actions are similar to the ones we today perform when we as a society deal with elderly people, senile family members or patients with a psychological condition. Often, those people need lots of time and attention. And in our society with everyone being busy and public healthcare underpaid and understaffed, those people often are put into care homes, out of sight, are being sedated, isolated and ignored. Treated with medication to keep them quiet and under control.
Janeway does a similar thing: She neither has time nor patience to deal with the doctor's mental condition. She rather erases parts of his memory, to "fix" him without the need to deal with those problems anymore. She resets the doctor to a state that she feels comfortable with. This is unacceptable. If another crew member would have shown the same mental breakdown, she hardly would have performed a lobotomy on him to get rid of this problem.
And Seven of Nine is the only crew member that speaks out loud. A disgrace for anyone else on board of Voyager! Even Mr "Morale Officer" Neelix, that normally is concerned about the crew's mood and tries to help them, has absolutely no words of comfort or understanding for the doctor and rather calls for a security team to have him arrested. That is weak. Even after Janeway has realized her mistake and doesn't delete the doctor's memory a third time, there is still no one on board that talks to the doctor, tries to understand his feelings and pain and makes him feel better by sharing stories and listen to him. Janeway instead feels annoyed, bored by his ranting. They just keep company so he doesn't delete his program himself. But there is no counseling, no comforting, no understanding, no help, no friendship, no connection.
The crew still treats the doctor like a computer program with a glitch and hope, this bug fixes itself somehow. A very disappointing portrayal of team solidarity and friendship. Without the doctor, half the crew at least would have already been dead, the Kazon would have stolen their ship, Starfleet wouldn't know Voyager is in the delta quadrant... but the crew repays their gratefulness by deleting unwanted memories from the doctor's database. Next time the doctor should just through the whole crew out of the nearest airlock and then work on his opera career with all the free time he then will have.
And what is with this ensign that miraculously appears just for this episode? Was she hiding for five years in a dark corner in engineering? And couldn't the prop makers think of any smaller and thinner camera, just like a smartphone maybe? Instead cameras in the 24th century are as big as those from the early 20th century - not even to mention that a tricorder obviously can't take photos.
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